Individual provider Active NPI

Nitisha Mehta

  • Pediatrics Physician
  • Oakland, CA
National Provider Identifier
1205577038
Registry record updated Jun 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A190916 Issued in CA
Practice address
747 52ND St
Oakland, CA 94609-1809
Phone
(408) 300-4477
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X A190916 CA Primary

Addresses

Primary practice location

747 52ND St
Oakland, CA 94609-1809

Mailing address

747 52ND St Ste 245
Oakland, CA 94609-1809
Phone (510) 428-3331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250725002938 CA Practitioner - Pediatric Medicine 9537676416 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A190916CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Pediatrics CurrentSince Jun 8, 2025 Accepting new patients
University of California San Francisco CurrentSince Jun 8, 2025 Accepting new patients
UCSF Pediatrics Associates Pediatrics CurrentSince Jun 8, 2025 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 8, 2025 Accepting new patients
University of California San Francisco Pediatrics Current Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 8, 2025 Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

8711 MacArthur Blvd
Ste A
Oakland, CA 94605

5220 Claremont Ave
Oakland, CA 94618
Phone (510) 428-3129

747 52nd St
Oakland, CA 94609
Phone (510) 428-3070

747 52nd St
Ste 245
Oakland, CA 94609
Phone (510) 428-3331

2607 Myrtle St
Oakland, CA 94607
Phone (510) 238-8607

5400 Telegraph Ave
Oakland, CA 94609
Phone (510) 428-3226

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

Interoperability endpoints

  • Direct secure messaging: nmehta81721@direct-ucsfmedicalcenter.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749340800000",
    "number": "1205577038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 52ND ST STE 245",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "408-300-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "NITISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2025-06-08",
        "certification_date": "2025-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A190916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.